Upcoming Health Care Reforms: Stepping Up to the Challenges

Abstract

From the Rush University College of Nursing, Chicago, IL. Corresponding Author: Kathleen R. Delaney, PhD, PMH-NP, Rush University College of Nursing, 600 S Paulina St, Chicago, IL 60612. E–mail address: kathleen_r_delaney@rush.edu © 2010 Elsevier Inc. All rights reserved. 0883-9417/1801-0005$34.00/0 doi:10.1016/j.apnu.2010.04.005 FOR FOUR CONSECUTIVE years, I headed my church rummage sale. This was a weeklong affair that required about 40 daily volunteers to sort and organize rummage until it eventually filled the entire gym and more. One year, midweek, everything seemed to be going wrong. Tables had not been delivered and necessary parts of the gym were partitioned off. Many volunteers were agitated, coming to me and looking for answers to how we would get our work done. At one point, I was standing with five women, in the kitchen area off the gym, and they collectively decided, “Let's just go out there and figure out a way to make it work.”As I gratefully agreed, it struck me that every one of the women in this group happened to be a nurse. Indeed, nurses are very good at stepping up to challenges, getting the work done, and doing it right. I often think that this attitude is acculturated early, when as a new nurse, one is faced with difficult situations and has no choice but to step up and take responsibility for addressing the circumstances they confront. Collectively, psychiatric nursing is now facing such a situation. The challenge is rising from the combined effects of health care reform and health care parity legislation on access to care. Estimates are that an additional 5.2 million persons will soon have behavioral health care coverage. Of course, access to treatment for the previously uninsured is a good thing. But it brings with it issues of the adequacy of the infrastructure of our behavioral health care systems, reimbursement issues, integration with primary care, information technology (IT) readiness, and workforce capacity. How will behavioral health care respond? This was the focus of a recent Behavioral Health Care Summit hosted by the American College of Behavioral